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3551 Highland Ave Ste 200b Downers Grove IL 60515-2100 | |
| (630) 264-8720 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 3551 Highland Ave Ste 200b, Downers Grove, Illinois |
| Authorized Official Name and Position | Kara Richardson (VP MANAGED HEALTH) |
| Authorized Official Contact | 7046310450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
29373 Network Pl Chicago IL 60673-1293 Ph: () - | 3551 Highland Ave Ste 200b Downers Grove IL 60515-2100 Ph: (630) 264-8720 |
| NPI Number | 1982329173 |
|---|---|
| Provider Enumeration Date | 10/10/2022 |
| Last Update Date | 12/02/2024 |
| Medicare PECOS PAC ID | 7810800935 |
|---|---|
| Medicare Enrollment ID | O20231027001471 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982329173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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